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Open Access Research article

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003

Rosa Puigpinós123*, Carme Borrell124, José Leopoldo Ferreira Antunes5, Enric Azlor1, M Isabel Pasarín124, Gemma Serral1, Mariona Pons-Vigués12, Maica Rodríguez-Sanz12 and Esteve Fernández67

Author Affiliations

1 Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain

2 CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain

3 Departament de Salut Pública, Facultat de Medicina. Universitat de Barcelona, Barcelona, Spain

4 Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra., Barcelona, Spain

5 School of Dentistry, Universidade de São Paulo, São Paulo, Brazil

6 Tobacco Control and Research Unit, Institut6 Català d'Oncologia (ICO-IDIBELL), l'Hospitalet de lobregat (Barcelona), Spain

7 Department of Clinical Sciences, Campus of Bellvitge, Universitat de Barcelona, l'Hospitalet de Llobregat (Barcelona), Spain

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BMC Public Health 2009, 9:35  doi:10.1186/1471-2458-9-35

Published: 23 January 2009



The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003.


The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992–1994, 1995–1997, 1998–2000, and 2001–2003).


Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers.


This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.